Almost half of adults living in the U.S. age 30 and over have periodontal disease, according to a recent study1 by researchers from the Centers for Disease Control and Prevention (CDC). The study, published in the Journal of Dental Research, estimates that over 47% of adults, representing 64.7 million adults, had periodontitis—38% of the adult population age 30 and older and 64% of adults age 65 and older had either moderate or severe periodontitis.
The study also reaffirmed sociodemographic disparities in oral health found in previous national surveys. Men were more likely than women to suffer from periodontal disease. Among the racial and ethnic groups studied, Mexican Americans had the highest prevalence of periodontitis. Periodontitis was more prevalent in current smokers, and increased with increasing poverty levels and lower education.
New methods for estimating periodontitis
The levels of periodontal disease reported in the study, based on data from the 2009 and 2010 National Health and Nutrition Examination Survey (NHANES) cycle, are higher than previous national surveys—but not necessarily because periodontitis is on the rise. According to the researchers, this study is more likely to capture a true estimate of periodontal disease because it marks the first time the national survey has used a full-mouth periodontal examination (FMPE), rather than a partial mouth periodontal examination (PMPE). Surveys using PMPE protocols used measurements from only selected quadrants of the mouth or up to 3 sites per tooth—and may have missed disease in teeth that were not examined. In contrast, the FMPE protocol measured attachment loss and probing depth from 6 sites per tooth for all teeth (except third molars). Given the uneven distribution of periodontitis in the mouth, previous estimates based on PMPE may have significantly underestimated actual prevalence rates.
In Canada, according the Canadian Health Measures Survey (CMHS), approximately 80% of adults (with teeth) are considered to be healthy in terms of loss of attachment, despite the finding of gingivitis in almost one-third of adults age 20 to 79. Dr. Amir Azarpazhooh, assistant professor in the faculty of dentistry at the University of Toronto, says, “These numbers sound good compared with the recently published CDC study; however, making direct comparisons between the findings of the CDC study and the CMHS study is actually limited—especially when we consider that important methodological differences exist between these two valuable studies.” One key methodological difference is that the CMHS data were derived from only 8 molar and 2 anterior teeth, compared to the full mouth data from NHANES.
NHANES will continue into 2014. Researchers plan to expand their sampling of certain subsets of the study population to improve their estimates of an important dental public health problem in the adult U.S. population.
- Eke PI, Dye BA, Wei L, Thornton-Evans GO, Genco RJ, Beck J, et al. Prevalence of Periodontitis in Adults in the United States: 2009 and 2010. J Dent Res. 2012;91(10):914-20. Epub 2012 Aug 30.